In This Issue

In June 2008 the Association of American Medical Colleges' Group on Resident Affairs defined 11 core competencies and responsibilities of institutional leaders of graduate medical education (GME).1 Beyond maintaining the accreditation of GME programs and sponsoring institutions, the responsibilities and competencies of designated institutional officials (DIOs) described in this document include improving the quality of the educational program, supporting and developing residency program directors, managing the GME budget and operations, overseeing the well-being of residents, providing guidance on legal matters related to resident education, operating in the larger context of medicine and health policy, and ongoing professional and self-development.

A sizable number of articles in the June 2010 issue of the Journal of Graduate Medical Education delve into topics related to 1 or more of the roles and competencies relevant to sponsoring institution management and oversight. Yet these articles are equally relevant to program directors and faculty. In their editorial, “Beyond Must: Supporting the Evolving Role of the Designated Institutional Official,” Lisa Bellini, Diane Hartmann, and Larry Opas (p 147) describe the information needs that result from DIOs' broad responsibilities and offer their personal experience as DIOs as context for the institutional matters section in this issue. Articles pertaining to institutional concerns include the summary of the benefits of GME programs by Pugno and colleagues (p 154), and the analysis of faculty perceptions of roles, responsibilities, and resource needs related to resident education by Woods (p 195).

Articles that offer practical information and guidance for institutional leaders include the description by Andolsek and colleagues (p 160) of an institutional template for annual program reviews and the Duke Medical Center's experience with this tool, the article by Cottrell (p 170) on an approach for sponsoring institutions to assist program directors and coordinators in maintaining and sustaining residency programs, the summary by Norby (p 206) of the mentoring needs of subspecialty program directors, the account by Joyce and colleagues (p 165) of using a checklist to enhance residents' interpersonal and communication skills, and the summary by Reznek et al (p 222) of the development and testing of a comprehensive quality and safety curriculum for residents.

Original research that may lend itself to adoption or adaptation by other institutions and programs includes a study of residents' understanding of their resource utilization (Dine et al, p 175), variations in billing in clinics where residents participate in care and their financial implications on the medical center (Kapa et al, p 181), and the effect of an educational intervention on resident reporting of adverse events (Jericho et al, p 188). In a multicenter study, Guille et al (p 210) researched the depressed first-year residents' use of mental health services as well as the barriers that prevented them from obtaining care.

Other articles in this issue describe a resident scheduling model to enhance patient access and satisfaction in a pediatric continuity clinic (Tuli et al, p 215), a study of residents' and faculty physicians' perceptions of teaching and learning during night float rotations (Bricker et al, p 236), and 2 studies of skills and performance by new first-year residents related to hand hygiene compliance (Gluck et al, p 228) and physical examination skills (Ramani et al, p 232), respectively.

In the section on teaching, learning, and assessment, articles include a comprehensive approach for evaluating and remediating residents with performance deficiencies (Wu et al, p 242); resident preparation, confidence, and attitudes about chronic noncancer pain (Yanni et al, p 260); smoking cessation (Johns et al, p 283); and use of advanced directives (Colbert et al, p 278). Warm and colleagues (p 269) describe a comprehensive approach for multisource evaluation in the ambulatory setting, and 2 articles describe education and assessment of anesthesiology residents (Gaiser et al, p 246 and Soto et al, p 250).

In the “Environment and Context” section, Black and colleagues (p 289) describe the use of social networking sites by physicians-in-training and offer prudent advice to residents and their programs and institutions. Stewart (p 294) describes Johns Hopkins' novel approach to internal medicine-pediatrics training as a way to address the primary care deficit in inner city urban areas. In a commentary, Shimahara and colleagues (p 297) discuss the variability in grade and achievement reporting among medical schools and the consequences for the resident selection process.

In the “ACGME News and Views” section Doughty and colleagues (p 300) report on more than a decade of experiential leadership training for pediatric chief residents and course participants' and their program leaders' perception on the benefits of this training, as well as a the results of an Accreditation Council for Graduate Medical Education pilot to assess the feasibility of identifying performance excellence at the institutional level.

Most of the articles in this issue transcend the individual residency program, and the research and descriptions of practical intervention offer guidance to program and institutional leaders on a range of program and institutional concerns and opportunities for ongoing development and improvement, reflecting our desire to make the JGME an indispensable resource for program and institutional leaders.